Provider First Line Business Practice Location Address:
12525 E MISSION AVE
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99216-1063
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-928-1500
Provider Business Practice Location Address Fax Number:
509-928-8006
Provider Enumeration Date:
10/27/2009